Nutrition

Vitamin A

The problem: about Vitamin A deficiency

Vitamin A is essential for the functioning of the immune system. Giving vitamin A supplements to children who need them increases their resistance to disease and improves their chances of survival, growth and development.

Vitamin A deficiency (VAD) is a global problem. It affects more than 100 million children and is responsible for as many as one out of every four child deaths in regions, countries and communities with a deficiency of vitamin A. Now, there is also increasing evidence that VAD increases the risk of maternal death.

In the past, VAD has been seen merely as a cause of blindness, and in many countries, vitamin A activities are still limited to blindness prevention programmes. In other countries, no action has been taken and no assessment of the problem exists.

The solution: supplementation, fortification, breastfeeding

There are a number of ways to improve the vitamin A status of populations. Vitamin A-rich foods are not always readily accessible to people who need them. In many parts of the industrialized world, food products are fortified to ensure that populations receive adequate amounts of the vitamin. In many developing countries, vitamin A supplementation is the fastest and most cost-effective approach to improving the vitamin A status of the population because it is:

- Cost-effective- Safe- Sustainable- Easily implemented on a national scale- Can be carried out for many years.

Supplementation using vitamin A capsules should begin at six months old in areas where children do not get enough vitamin A in their diets. The potential for reducing deaths is very high, and the benefits of high-dose supplements far outweigh the very rare and transient side effects. Capsules cost just a few cents each and can be distributed through expanded programmes on routine immunization and National Immunization Days, or other public health contacts.

Breastfeeding support is key to reducing VAD among young children. New mothers should receive high-dose vitamin A supplementation within eights weeks of delivery in areas where deficiency exists.

In some countries, where there is adequate industrial and commercial infrastructure, fortifying food staples such as flour, sugar and margarine can help end VAD. Fortification can be very cost-effective. Dietary improvement, including ensuring regular access to foods that are naturally rich in vitamin A, will be part of a long-term strategy in many countries.

The impact: Vitamin A supplementation saves lives

Improving the vitamin A status of children:

Increases their chances of survival:- Reduces death from measles by 50 per cent - Reduces death from diarrhoea by 40 per cent - Reduces overall mortality by 25 per cent.

Reduces the severity of childhood illnesses:- Less strain on clinic and outpatient services- Fewer hospital admissions- Contributes to the well-being of children and families.

Other possible health benefits:

- Prevents night blindness, xerophthalmia (a drying of the conjunctiva and cornea), corneal destruction and blindness- May reduce birth defects- May prevent several types of cancer, including that of epithelial tissues such as skin and mucous membranes

Is cost-effective:- Just a few cents per capsule- Reduces health costs by lessening hospital and clinic visits- Easily integrated into existing public health/immunization programmes.

Goal

Eliminate vitamin A deficiency worldwide by 2010.

How can this be achieved?

The Vitamin A Global Initiative is an informal network of donors and international organizations. Partners include UNICEF, the Micronutrient Initiative (MI), the Canadian International Development Agency (CIDA), the World Health Organization (WHO), and the United States Agency for International Development (USAID).